APOE genotype influences functional status among elderly without dementia

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Abstract
The presence of apolipoprotein‐ϵ4 (APOE‐ϵ4) significantly increases the risk of Alzheimer's disease (AD). The association between APOE‐ϵ4 status and functional abilities was explored further in a multicultural sample of community‐dwelling, non‐demented elders. The sample was limited to cognitively‐intact, community‐dwelling elders, who were free of stroke or other neurologic disability. In 218 elders who met research criteria, the presence of APO‐ϵ4 was associated with poorer functional status, apart from the effects of neuropsychological performance, gender, age, and education (OR = 2.5, 95% CI: 1.3, 4.9). In 158 subjects without an APOE‐ϵ4 allele, 50% reported no functional limitation; in the 60 subjects with an ϵ4 allele, only 28% reported no functional limitation (P < .01). The relationship was not explained by the distribution of co‐morbidities. The association between poorer function and the presence of an APOE‐ϵ4 allele was evident in each ethnic group. In path analyses, the presence of an APOE‐ϵ4 allele was associated with decreased functional ability in non‐demented elders not simply through an association with poorer cognitive status, but also independently. These results suggest that the APOE‐ϵ4 genotype is associated with functional deficit in people with normal neuropsychological profiles.